Provider Demographics
NPI:1497252654
Name:FARINAS, VICTORIA CHRISTINE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:CHRISTINE
Last Name:FARINAS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3441 SW 87TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-4219
Mailing Address - Country:US
Mailing Address - Phone:786-683-8839
Mailing Address - Fax:
Practice Address - Street 1:14291 SW 120TH ST STE 103
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7287
Practice Address - Country:US
Practice Address - Phone:305-385-0168
Practice Address - Fax:305-385-0182
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-12
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ9249235Z00000X
FLSA18267235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104125600Medicaid